Conducted at
**Institute of Science, Technology and Public Policy, and **Center for Health
and Aging Studies, Department of Physiological and Biological Sciences, and
Department of Management, and Departments of Chemistry and Physiology, Maharishi
University of Management, Fairfield, IA

Summary

The competitive nature of managed care organizations demands that
providers seek cost-effective ways to maintain the health of their clients. As
an approach to reducing cardiovascular morbidity and mortality, antihypertensive
medication is costly, has adverse side effects, and has questionable value in
reducing coronary heart disease. This report evaluates a behavioral
stress-reduction method as an option to pharmaceutical treatment. Randomized
studies indicate that the Transcendental Meditation® (TM) technique reduces mild
hypertension (the predominant form of hypertension) as effectively as do drug
therapies. A cost-effectiveness comparison in 1996 dollars was conducted among
five standard antihypertensive medications and the TM technique over a simulated
20-year treatment period.

According to present value analysis of treatment payments, the TM technique had
the lowest present value cost, and thus appeared to be the most attractive
alternative. The estimated average cost of antihypertensive drug treatment
ranged from $375 per year for hydrochlorothiazide to $1,051 per year for
propranolol hydrochloride, whereas the estimated average cost of treatment with
the TM technique was $286 per year. When combined with results of controlled
trials documenting the effectiveness of the TM technique in reducing high blood
pressure, decreasing morbidity and mortality, and improving the quality of life,
the present comparison suggests that this nonpharmacologic procedure may be
safely used as a cost-effective treatment of hypertension in the managed care
setting.

Transcendental Meditation® Program Study #2

Title
The Impact of the Transcendental Meditation Program on Government Payments to
Physicians in Quebec: An Update

Conducted at
* Department of Management and Public Administration, Maharishi University of
Management, Fairfield, IA 52557
** Department of Statistics and Actuarial Science, University of Iowa, Iowa
City, IA

Summary

This study expands upon a previous study conducted by the authors
to analyze whether practice of the Transcendental Meditation (TM) technique
affected government payments to physicians in Quebec, Canada. The present study
includes data on an additional 741 practitioners of the TM technique (for a
total of 1418 TM subjects) and a comparison subject for each TM practitioner,
and extends the time period three additional years. This retrospective,
longitudinal study compared data on government payments to physicians for
treating 1418 health insurance enrollees in Quebec who practiced TM and 1418
comparison subjects who did not practice TM. Data for pre-intervention and
post-intervention periods over a time period of 14 years was analyzed. The TM
subjects had practiced TM for an average of 6.7 years and participated in the
study by filling out a questionnaire. They were considered a convenience sample
since they were self-selected, the number of questionnaires distributed was not
known, and the number of possible respondents was not known. The comparison
group for this study was randomly selected by the Quebec health insurance
agency, matching each TM subject with a comparison subject having the same age,
gender, and region in which they lived. The total number of study subjects was
2836, including 1408 men and 1428 women, with an average age of 38 years. The
subjects' annual physician expenses for the years 1981-1994 were adjusted for
inflation and analyzed in constant 1992 Canadian dollars. For the
preintervention period (before subjects started the TM technique), the yearly
rate of increase in payments to physicians was not significantly different
between the TM and comparison groups. For the post-intervention period (after
the subjects started TM), the yearly payments to physicians for the comparison
group increased to levels that were higher than the preintervention levels for
this group, increasing up to 11.73% annually over a six-year period. In the TM
group however, the yearly payments decreased 1% to 2% annually in the
post-intervention period, resulting in a significant mean annual difference of
13.78% (p=0.0017), compared to the non-TM group. These data suggest that
practice of the TM technique reduced payments to physicians between 5% and 13%
per year over a six-year period, compared to the control group. This type of
reduction in medical expenditures could result in billions of dollars saved by
governments and private health insurance companies in nations experiencing
rapidly rising health care costs.